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What is Necrosis?
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What is Necrosis?

My bx showed necrosis phase 3.  One of the docs told me fibrosis is the current term for necrosis.
It is confusing.  The docs confirmed I have compensated cirrhosis.  Where does the fibrosis/necrosis fit into the cirrhosis progression?
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223152_tn?1346981971
necrosis is cell death.

Fibrosis is scarring, and it leads to necrosis.  THe heptocytes (liver cells) do not function if they are dead.  Janis 7 has a lot of good stuff on this

http://janis7hepc.com/biopsies.htm#stages%20of%20progression

Cirrhosis

When fibrosis becomes widespread and has progressed to the point where the internal structure of the liver has become abnormal, fibrosis has progressed to cirrhosis. Cirrhosis is the result of long term liver damage caused by chronic inflammation and liver cell death. The causes of cirrhosis include viral hepatitis, excessive intake of alcohol, inherited diseases, and hemochromatosis (abnormal handling of iron by the body).

Cirrhosis is accompanied by a reduction in blood supply to the liver. The loss of healthy liver tissue and the reduced blood supply can lead to abnormalities in liver function. Even when liver disease has progressed to cirrhosis, it may still be possible for the damage to be at least partially reversed if the underlying cause can be eliminated. Cirrhosis progression can usually be slowed or even stopped with treatment.

The onset of cirrhosis is usually silent, with few specific symptoms to identify this development in the liver. As scarring (fibrosis) and destruction continue, some of the following signs and symptoms may occur: loss of appetite, nausea and/or vomiting, weight loss, change in liver size, gallstones, itching, and jaundice. However, a large number of people live many, many years with cirrhosis without any decompensation or symptoms.

It is important to know that once cirrhosis develops, it is critical to avoid further progression of the disease. The consumption of alcohol in any form, including such things as certain mouthwashes and cough medicines, must be completely avoided by people with cirrhosis.

If you have cirrhosis, this may be a time to reevaluate your treatment goals. If you have not had interferon-based therapy, you may want to consider it or other available treatments that aim to eradicate the virus. It may also be time to look into other means of improving the health of your liver.
frijole
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223152_tn?1346981971
The chart doesn't format too well, but this still gives you and idea.  It is very fortunate that you have decided to treat.  You said you were clear at 16 weeks.  Were you clear at 12?  If not, have you decided to go 72 weeks?  This would probably be advisable given your stage.
frijole

Table 1.
Comparison of Scoring Systems: Periportal Necroinflammatory Changes
Score Original HAI[a](3) Modified HAI(4) Metavir[b](5)
0 None Absent Absent
1 Mild piecemeal necrosis Mild (focal, few portal areas) Diffuse alteration of the periportal tract in some portal tracts or focal
2   Mild/Moderate (focal, most portal areas) Diffuse alteration of the periportal tract in some portal tracts or focal
3 Moderate piecemeal necrosis (involves less than 50% of the circumference of most portal tracts Moderate (continuous around 50% of tracts or septae)
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248382_tn?1274942234
Hi frijole,

Thanks for the information.  It is very helpful.  Finally the fibrosis/necrosis makes sense.

Yes, I didnot clear until wk. 16 and my doc said i would go the full 72.  After cbc at week 18, doc reduced procrit from once a week to once every 2 weeks because my white & red count had improved.  And she said I did not have to go on neupogen.  I have a pack of neupogen "just in case".

Any suggestions on other treatments?  

Jenn
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